| NPI | 1740376540 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY A INGRAM Endodontist 210-617-8536 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: TX 17400) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: TX 18608) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2020-08-22 |